ArticleCureus2026
Early-Onset Hemophagocytic Lymphohistiocytosis and Inflammatory Neurotoxicity Prior to Post-transplant Cyclophosphamide: A Report of Two Cases.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
We report two distinct, early hyperinflammatory toxicities after human leukocyte antigen-mismatched allogeneic hematopoietic cell transplantation with post-transplant cyclophosphamide in adult recipients. Case 1 developed severe cytokine release syndrome with shock, respiratory failure, renal failure, hyperferritinemia (22,771 ng/mL), hypertriglyceridemia (1,024 mg/dL), and multiorgan dysfunction, consistent with secondary hemophagocytic lymphohistiocytosis; he improved rapidly after receiving emapalumab. Case 2 developed fever and abrupt encephalopathy on day +2 with negative infectious and neurologic evaluation and rapidly improved after tocilizumab, consistent with cytokine-mediated neurotoxicity resembling immune effector cell-associated neurotoxicity syndrome. These cases highlight diagnostic overlap with infection and the need for early immunosuppressive intervention.
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